Cross-sectional associations between body mass index, waist circumference, and multimorbidity: Pró-Saúde study

Abstract

Background This study aimed (1) To investigate the association between the Body Mass Index (BMI) and waist circumference (WC) with multimorbidity (MM), and (2) To identify patterns of MM and investigate the relationship between BMI and WC with specific combinations of MM (patterns of MM). Methods A cross-sectional study was conducted with 2,698 participants of the fourth phase of the Brazilian Longitudinal Study of Adult Health (Pró-Saúde Study). MM was defined by the presence of two or more morbidities. MM patterns were identified by exploratory factor analysis based on tetrachoric correlations. Logistic regression models were used to assess associations (odds ratios (OR) with the respective confidence intervals (CI)). Results Of the total number of participants, 39.5% were overweight and 30.0% were obese; 89.0% (n = 1,468) of women and 77.0% (n = 952) of men were abdominally obese. Indeed, 60.7% (n = 1,635) was identified with MM. For the category four or more morbidities, OR values of 5.98 (95% CI 4.84–7.13) and 7.48 (95% CI 6.14–8.18) were found for each point of increase in BMI, and 6.74 (95% CI 5.48–7.99) and 8.48 (95% CI 7.64–9.29) for each additional centimeter in the WC, for female and male, respectively. Five patterns of MM were identified: respiratory, osteoarticular, cardiometabolic, gastric, and thyroid diseases (56.4% of the total variance). Positive associations were found between BMI and patterns of cardiometabolic, osteoarticular, thyroid and gastric diseases (higher OR of 1.09 [95% CI 1.04–1.14]) and less pronounced between WC and patterns of cardiometabolic and osteoarticular (higher OR of 1.04 [95% CI 1.03–1.04]). Conclusions The results showed that an increase of both BMI and WC was associated with a higher number of morbidities and with patterns of cardiometabolic and osteoarticular diseases.

Association of changes in waist circumference, waist-to-height ratio and weight-adjusted-waist index with multimorbidity among older Chinese adults: results from the Chinese longitudinal healthy longevity survey (CLHLS)

“…The association between adiposity and multimorbidity has been extensively explored in epidemiological studies [12,23,24,[36][37][38]. For instance, a systematic review and meta-analysis of 8 longitudinal studies found a higher risk of multimorbidity among individuals with obesity [36].…”

“…Several studies, mainly cross-sectional studies have explored the association between obesity and multimorbidity in older adults based on anthropometric indicators, and generally indicated that obesity is a risk factor for multimorbidity [12,[22][23][24]. Obesity is dynamically changing and may be more relevant with multimorbidity, but studies concerning the association between changes in obesity and multimorbidity are limited, particularly among older Chinese adults.…”